Nobody expects a person beginning an exercise regimen to run a marathon or to enter a bodybuilding contest. Setting impossibly high standards only guarantees failure. But if a person starts with easy goals and works her way up, she is much more likely to makeexercise part of her daily routine.

A good beginning regimen might include ten to twenty minutes of aerobic exercise, followed by a few weight-bearing exercises, three times a week. Everyone should work at her own pace until she is working out daily or at least three to five times per week. But even if a person can exercise only for a few minutes at a time, there is no need to despair. Doing a little exercise is better than doing none at all. It will get easier as time goes on.

When a person is in an acute phase of hepatitis or is experiencing a severe exacerbation or relapse of disease, any form of intense exertion should be avoided. There's no need for enforced bed rest, however. A person should listen to her body. If she is exhausted, then it's time to rest. If she's up to physical activity, then by all means sheshould be active. But, she must be aware of her personal limitations and know when it's time to call it quits. The liver has only so much energy to distribute to the rest of the body, so it's never wise to overdo it. Again, it is essential to consult with your doctor prior to commencing any exercise program.

Weight-bearing exercises build up both bones and muscles. For many reasons, it isimportant for all people with liver disease to incorporate weight-bearing exercises intotheir daily exercise routines. First, people with liver disease need good strong bonesbecause they are prone to osteoporosis. Weight training is the best way to fight againstthis, as stronger muscles equal stronger bones. Second, in advanced stages of liverdisease, the body is forced to recruit muscle as a source of energy, and people are at riskof developing severe muscle wasting and greatly diminished strength. However, if aperson has a reserve of muscle built up on her body, it will take a much longer time forthis complication of liver disease to develop. Third, people who have too much fat ontheir bodies are at risk of worsening their underlying liver condition by developingnonalcoholic fatty liver disease (NAFLD). Weight training reduces the amount of fat onthe body and increases muscle mass. Therefore, the chance of developing NAFLD will bereduced. Finally, since muscle weighs more than fat, weight training is the perfect meansof gaining lean healthy weight for those people who are underweight.One exception to weight training should be mentioned. People with cirrhosiscomplicated by esophageal varices should avoid weight training. This is because walltension in the esophagus may drastically increase with weight training which puts thisgroup at increased risk for esophageal variceal rupture and hemorrhage.Once again, there are lots of self-help books and videotapes that describe how tocreate a personalized weight-bearing exercise routine. It's a good idea to hire a personalfitness trainer, who can design a personalized routine specific to an individual's needs. Itis important that the trainer be aware of the client's liver disorder, and that consequently,the client will not always be able to exercise to her fullest capacity. A person with liverdisease should never push herself excessively, nor should she allow herself to be pushedby a trainer. If she feels too tired or if a body part feels strained, she should stopexercising until she feels better. Fitness training has become a field that requirescertification, so make sure that the trainer is certified.It is important to remember to work out every part of the body evenly. Did you knowthat there are eleven distinct body parts to work out! In that way, the chances of injury aredecreased. A few stretching exercises should always be performed first to warm up themuscles before doing weight-bearing exercises. The amount of weight being lifted shouldallow for eight to twelve repetitions. Each repetition (rep) is defined as one full andindividual execution of a particular lifting exercise. A set is a distinct grouping ofrepetitions, followed by a brief rest interval. Three sets of a given type of exercise shouldbe performed. Aim to work out each body part at least once a week. Twice a week is ideal.View Thread

Aerobic exercise trains the heart, lungs, and entire cardiovascular system to process anddeliver oxygen more quickly and efficiently to every part of the body. It's the kind ofexercise that gets the heart pumping. As one becomes more aerobically fit, the heartwon't have to work as hard to pump blood to the rest of the body, including the liver. Thepulse will begin to slow down, making it easier for the liver to send back to the rest of thebody the blood it has just filtered. The benefits of being an aerobically fit person includean overall improved energy level, which translates into decreased fatigue. Fortunately, aperson does not have to purchase high-fashion workout clothes or go to a fancy gym toget aerobic exercise. Walking briskly, bicycling (either stationary or regular), swimming,or using a treadmill all provide solid aerobic benefits. Many people start off withsomething easy, such as walking around the block. A helpful hint is to start by walking upand down the street close to home. In that way, if a bout of fatigue suddenly occurs, itwon't take long to get home.View Thread

People with liver disease should take up both aerobic and weight-bearing exercises, asthey each play a different role in fighting liver disease. It is fortunate that there are anabundance of books, videotapes, and television programs that teach, step by step, bothtypes of exercises. It is important to use these self-help materials prior to starting anyexercise regimen. Other helpful ideas include scheduling a few appointments with apersonal trainer to design a fitness routine that personally meets the needs of a personwith liver disease. Many fitness trainers will even work in their clients' or the trainer'shomes. And recently, one-on-one fitness training facilities have become widespread.They offer both privacy and personalized attention. This is important, as many people aretoo self-conscious or too shy to exercise in a crowded gym, and/or lose self-motivationafter the first few sessions at a gym. A welcome development has been the appearancevery recently, of gyms geared specifically to individuals who are not in good shape. Inthese facilities, embarrassment is mitigated and the convergence of similarly situatedclientele creates an environment akin to a combination support group/health club. Finally,the likelihood of success is increased if a person adopts an exercise program that shealready enjoys and that can easily be adhered to with consistency at least three times aweek.Timing is also important. It is fine to exercise at any time of the day that is personallyconvenient. However, by the end of the day, most people are usually too mentally andphysically tired to do anything, least of all, run on a treadmill! That is why most peoplewith liver disease find that they need to do their exercises first thing in the morning.While some people may find it difficult to get up in the morning in the first place, oncethey get started with an exercise regimen, it will become easier and easier. And peopleusually find that exercising in the morning helps give them an extra boost of energy tomake it through the day. Finally, don't overdo it. It's more important to maintain a regularroutine than to set any records.Aerobic ExercisesAerobic exercise trains the heart, lungs, and entire cardiovascular system to process anddeliver oxygen more quickly and efficiently to every part of the body. It's the kind ofexercise that gets the heart pumping. As one becomes more aerobically fit, the heartwon't have to work as hard to pump blood to the rest of the body, including the liver. Thepulse will begin to slow down, making it easier for the liver to send back to the rest of thebody the blood it has just filtered. The benefits of being an aerobically fit person includean overall improved energy level, which translates into decreased fatigue. Fortunately, aperson does not have to purchase high-fashion workout clothes or go to a fancy gym toget aerobic exercise. Walking briskly, bicycling (either stationary or regular), swimming,or using a treadmill all provide solid aerobic benefits. Many people start off withsomething easy, such as walking around the block. A helpful hint is to start by walking upand down the street close to home. In that way, if a bout of fatigue suddenly occurs, it won't take long to get home.View Thread

Exercise is essential in order to decrease the incidence of potentially detrimental bonedisorders. Osteoporosis is a bone disorder frequently associated with liver disease. Itresults in decreased bone density, thereby leading to fragile, easily fractured bones. Whileosteoporosis is a disease that most frequently affects postmenopausal women, it can alsoaffect premenopausal women and men with liver disease. Postmenopausal women areparticularly susceptible to osteoporosis because, as estrogen production stops, bone lossaccelerates. Furthermore, women naturally have a lower percentage of muscle and bonemass than men. This further increases their risk of developing osteoporosis. Other risksfor osteoporosis in people with liver disease include excessive alcohol use, primarybiliary cirrhosis, advanced cirrhosis from any liver disease typically resulting in musclewasting, and the use of prednisone. Fortunately, people can reduce the likelihood ofdeveloping osteoporosis by making exercise and a healthy diet part of their lifestyle.Just as muscles grow in response to muscle contractions, bone strength and densityincrease when the muscles attached are contracting. Studies have shown that muscle andbone growth promoted by frequent weight-bearing exercise is vital to the prevention ofosteoporosis. Supplementing the diet with at least 1,000 to 1,500 milligrams per day ofcalcium in combination with vitamin D is also important. If a person already hasosteoporosis, it needn't keep her from exercising, but she will have to use more cautionso as to keep from breaking any bones. High impact aerobic exercises, which involvejumping and twisting, can increase the risk of injury and should be avoided. Low impactexercises, such as swimming and walking, are the safest choices for aerobic exercise.Weight-bearing exercises with light weights can generally be safely performed. Closeattention should always be paid to proper form. Running on a hard surface, such asconcrete pavement, should be avoided. Soft surfaces, such as specially designed runningtracks, a treadmill or a sandy beach, are preferable.View Thread

The benefits of exercising are numerous. First, exercise gives people a general sense ofwell-being and an improved self-image. It is a known fact that if a person feels wellmentally, her immune system will be stronger and give her that extra edge needed in thefight against disease.Second, as previously discussed, exercising gives a person a boost of energy. Fatigueis probably the most common as well as one of the most bothersome symptoms thatplagues people with liver disease. Many people with liver disease frequently feel likethey don't have enough energy to make it across the room, let alone around the block.However, the best way to fight this seemingly relentless exhaustion is to exercise. Yes,the notion of exercising when you are fatigued may seem counterintuitive- like a viciouscycle, but most people find that it actually works. In part, fatigue may have to do with thefact that both the heart and the liver are working overtime to keep a good supply offiltered blood circulating throughout the body. Adding a regular exercise routine enablesboth organs to work more efficiently. Over time, this will boost energy levels. While mostpeople find it tough going at first, they eventually realize that the benefits make it wellworth it.Third, exercise improves cardiovascular function. As the body gets stronger and moreaerobically fit, the cardiovascular system will be able to work more efficiently. Lesseffort will be required of the heart to pump blood to the liver and other body organs. Lesseffort on the heart equals stronger cardiovascular function and an increased overallenergy level for a person with liver disease. It is extremely important to attempt to dosome exercise while on interferon treatment, as this will decrease the fatigue, irritability,and depression often associated with this medication.Fourth, exercise results in a reduction of total body fat. While nearly everyone knowsthat being overweight places a great deal of stress on the heart, most people don't realizethat it also makes it harder for the liver to do its job. When total body fat is reduced, fatcontent in the liver is simultaneously reduced. This often results in a significant reductionof elevated liver enzymes, no matter what the underlying liver disorder is. Eating rightand getting plenty of exercise is undoubtedly the slowest way to lose weight known tohumanity, but it's also the safest and surest. This is especially true for people with liverdisease. Even intermittent exercise has been shown to be beneficial in obese women.Combining a healthy diet with regular exercise is also the best way to keep fromregaining the weight.View Thread

Regular exercise is an important component in the fight against liver disease. This isn'tsomething that can be found in any medical textbook or that is taught in medical schoolclassrooms. This may explain why most liver doctors don't realize how importantexercise can be to maintaining their patients' health. But I've seen the benefits over andover again in my practice. People who are in good shape and who exercise on a regularbasis not only feel better, but often respond more positively to medical treatment. Peopledo not have to do a lot of exercise in order to reap its benefits. Nor does it make sense tooverdo it. The main thing is simply to get going. Regular exercise will increase energylevels, decrease stress on the liver, and, in many cases, even delay the onset of certaincomplications associated with liver disease. For people with liver disease, it is crucial toconsult with a doctor before beginning any type of exercise program.View Thread

HBV is 100 times easier to transmit sexually than HIV ( the virus that causes AIDS). HBV has been found in vaginal secretions, saliva, and semen. Therefore, it doesn't matter if a person's sexual partner is of the same or the opposite gender. If one partner has hepatitis B, the other one can get it. Oral sex and especially anal sex regardless (whether it occurs in a heterosexual or homosexual context), are possible ways of transmitting the virus. It is not transmitted by holding hands, hugging or even dry kissing on the lips. The chance of transmission with deep kissing is unknown, as no infections have been definitively documented after exposure to infected saliva. Yet, since HBV has been found in saliva, the risk of transmission with deep kissing probably exists and the risk increases if one partner wears orthodontic braces or has open cuts or sores in the mouth. The likelihood of becoming infected with HBV grows with the number of sexual partners a person has. Thus, promiscuous individuals are more likely to get HBV. Also, men who have sex with men are 10-15 times more likely to catch HBV than the general population.View Thread

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